Biomedical subjects
Publications and source records attributed to G Inoue.
A case of dorsal dislocation of the triquetrum associated with a dorsal dislocation of the distal radioulnar joint is reported. Open reduction and transfixation with Kirschner wires was performed. Eighteen months afterwards, the patient had marked volar intercalary segment instability deformity of the wrist joint assessed radiographically, with approximately half loss of range of motion of the wrist and grip strength.
Oxygen-derived free radicals have been shown to play an important role in reperfusion injury. The protective effect of CV-3611, a new free radical scavenger, on reperfusion injury in an ischemic revascularized hind limb model in rats was examined. Warm ischemia (25 degrees C) was produced by vascular pedicle clamping and sustained for 0, 3, and 6 hr. Histologic and fluorochrome bone-labeling analyses demonstrated improved overall viability of osteocytes, osteoblasts, and marrow cells in the CV-3611-treated group compared to controls. The CV-3611-treated group had statistically significant improvement in the ratio of lacunae, maintained osteogenetic ability, and preserved normal growth plate architecture after 6 hr of ischemia. The control group showed local central areas of disorganization by 3 hr and complete destruction of the growth plate with early growth arrest after 6 hr of ischemia. These results indicate that administration of CV-3611 prior to reperfusion can prevent reperfusion damage in bone tissue and maintain osteogenetic ability. This technique may have clinical application for reducing the complications of prolonged ischemia to bone tissue.
This article presents two unusual cases of combined shear fractures of the trochlea and capitellum associated with anterior fracture-dislocation of the elbow. The mechanism of injury was thought to be a fall on the dorsum of a partially flexed forearm, in which the trochlea and capitellum are displaced by the fractured olecranon and the radial head.
Fourteen cases of mallet fingers with a displaced large fracture fragment and/or a subluxated distal phalanx were treated by closed reduction using extension-block Kirschner wire. The follow-up evaluations took place after a mean of 9 months. The results according to Crawford's criteria were eight excellent, four good, one fair, and one poor. This technique is simple, is easier than other techniques for reduction of mallet fractures, and is associated with a low morbidity.
To investigate the role of glucose in regulating glucose transporters in pancreatic beta-cells, we studied the hamster clonal beta-cell line HIT-T15, which retains responsiveness to glucose. Northern blot analysis demonstrates that GLUT2 and GLUT1 mRNA are abundant in HIT cells. After a 24-h culture with various concentrations of glucose (0-22.2 mM [0-400 mg/dl]), the GLUT2 mRNA level in HIT cells increased by 40% at 22.2 mM (400 mg/dl) glucose compared with 11.1 mM (200 mg/dl) without a change in mRNA stability. It also decreased proportionally to the reduction of glucose concentration. Glucose deprivation resulted in a decrease of GLUT2 mRNA to an almost undetectable level, with a marked increase in the degradation rate of mRNA. In contrast, the GLUT1 mRNA was not affected by glucose. We show that glucose uptake is highest in HIT cells incubated at 2.8-5.5 mM (50-99 mg/dl) glucose for 24 h, and that levels in cells cultured at 0 mM (0 mg/dl) and 22.2 mM (400 mg/dl) glucose decrease to approximately 20% of the maximum level. This decrease is consistent with the effects of glucose on glucose-stimulated insulin secretion in HIT cells. Our results indicate that glucose is involved in regulating GLUT2 mRNA and glucose uptake activity and that the glucose responsiveness of the insulin secretion correlates with the glucose-induced change in glucose uptake activity in HIT cells.
8 patients with Kienböck's disease and without negative ulnar variance were treated with a modification of Chuinard's capitate-hamate fusion. All patients returned to their normal activities free of pain. The postoperative wrist motion was unchanged, but the grip strength was increased.
Internal fixation with a Herbert screw was used to treat 70 ununited fractures of the carpal scaphoid. Bone grafts were utilised in all cases of nonunion (56) and in 10 out of 14 with delayed union. The results were assessed at a mean time of 13 months. Definite radiographic union was achieved in 90% of patients after a mean period of postoperative immobilisation of 5.4 weeks. Although the rate of union was basically the same as in Russe's series, the final functional results were better than those obtained by using his technique. The use of an image intensifier is essential to avoid technical problems.
In the patient with scarring of just the central band and lateral bands, there is a loss of active and passive flexion of the proximal interphalangeal (PIP) joint because the lateral bands have lost their normal volar shift. Surgical freeing of the lateral bands from the central band using parallel incisions may be required to allow full flexion of the PIP joint. This study reports on 10 patients with post-traumatic extension contracture of the PIP joint treated by lateral band release. All operations were successful, with an average gain in range of motion of 47.5 degrees. This technique is simple, quick, and can be performed effectively on an out-patient basis.
Fingertip reconstruction using a dorsal transposition flap was performed on 10 patients who had undergone traumatic oblique amputation (radial or ulnar) through the middle of the nailbed or transversely through the proximal third of the nailbed. All operations were successful, with a small area of tip necrosis in one flap. Flat nail growth occurred in all digits, with an average regrowth of 5 mm from the initial amputated level. This is a reliable one-staged method of functional and aesthetic preservation of the fingertip.
Two cases of successful digital replantation are presented in which arterial inflow was provided by a proximal arterial-to-distal venous anastomosis. This technique provides an alternative means for replantation when no suitable artery for anastomosis is available in the amputated part.
The arterial pattern in 13 cases of radial deficiency and six cases of ulnar deficiency was studied by arteriography. The radial artery was absent or hypoplastic in 84.6% of cases of radial deficiency and in 50% of cases of ulnar deficiency. A persistent median artery was seen in 76.9% of cases of radial deficiency and in 16.7% of cases of ulnar deficiency. In 12 hands, the deep palmar arch was small or absent, depending upon the degree of radial arterial dysplasia. The digital artery to the deficient digits was missing in some cases. The persistence of an embryonic vascular pattern in cases of radial deficiency and ulnar deficiency with dysplasia of the ulna suggests that the teratogenic injury may have been simultaneous, whereas ulnar deficiency without dysplasia of the ulna was not associated with arterial abnormalities in the forearm.
The present study was designed to see the effects of glucose on glucose transporter expression and glucose transport activity using cultured human skin fibroblasts. When the cells were incubated with various concentrations of glucose (11.1-44.4 mM), no differences were found in the HepG2 glucose transporter mRNA, protein levels and basal and insulin-stimulated 2-deoxyglucose uptake. Glucose deprivation, however, resulted in approximately 4-fold increases in the mRNA and 3-fold increases in the protein and the basal 2-deoxyglucose uptake. Chronic exposure to insulin increased the glucose transporter protein levels to similar degrees in the cells incubated with 11.1, 22.2 and 44.4 mM glucose accompanied by increases in the glucose transport activity. Effects of insulin on the glucose transporter mRNA and protein levels, however, were not evident in the glucose-deprived cells. It is concluded that glucose transport activity correlates closely with HepG2 glucose transporter expression in cultured human fibroblasts and that glucose (11.1-44.4 mM) does not affect the glucose transporter expression and glucose transport activity.
A patient with an extra digit arising from the forearm is reported. This is the first such case reported in the English-language literature.
Fourteen cases of fracture-dislocation of the proximal interphalangeal joint (PIPJ) were treated using extension-block Kirschner (K)-wire after closed or open reduction of the dislocation. The postoperative ROM of the PIPJ in the 14 patients averaged 94.4 degrees. A full ROM of the PIPJ was regained in 10 cases. This wire provides an alternative method to the use of extension block splintage in the management of such injuries.
Sixteen arterialized venous flaps, free flaps that have arterial blood only flowing through the vein of the flap, were applied to reconstruct skin defects of the big toe resulting from wrap-around flap transfers. There were seven complete successes, six partial successes, and three complete failures. The clinical course of the cases indicated that the donor site itself and flap tension due to postoperative edema might play key roles in flap survival. The success rates of the flap from the leg and foot donor sites (including partial survival cases) were 75 percent and 87.5 percent, respectively. Flaps from the leg donor site appeared to develop more extensive postoperative congestion and edema than those from the foot donor site, which had a negative effect on flap survival. Covering the big toe with this flap causes no significant morbidity. The technique may have potential indications for closing a big-toe defect after a wrap-around flap transfer.
Reinnervation of composite-tissue allografts was examined in a rat hind-limb transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of animals were studied. Group 1 consisted of 10 composite-tissue allografts using inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors. Recipient animals received 15 mg/kg/day CyA subcutaneously for three weeks and then twice weekly for three months. Group 2 consisted of 10 composite-tissue isografts undergoing no immunosuppression, and using F344 as both donors and recipients. Eight months after operation, electromyographic, histologic, and morphometric assessments of nerve regeneration were made. There were no significant electromyographic differences between these two experimental groups in amplitude and conduction velocity, but the levels were lower than in controls. The histologic patterns of nerve regeneration within the composite-tissue transfers were similar in the two groups. However, the fiber population in the regenerated nerves in the two groups was different from that in the normal sciatic nerve. This study confirmed the reinnervation of composite-tissue allografts under CyA immunosuppression. The quality of regeneration in allografts was similar to that in isografts, but the histologic and electromyographic properties of regenerated nerves were different from those of normal sciatic nerves.
A novel technique of composite free-flap and tendon transfer is introduced and used in four patients to repair complicated finger injuries involving loss of skin and tendon. This is a one-stage procedure, providing unbulky, high-quality tissue. Although the final range of motion was disappointing, with an average of 10 degrees, there is justification for further clinical trials in patients with loss of skin and tendon in the digits.
Fractures of the tibia through the proximal epiphysis are rare. This injury usually results from severe direct or indirect force about the knee, and has not been described as resulting from a patellar tendon avulsion injury. Four patients presented with five avulsion fractures of the proximal tibial epiphysis. All were older adolescent males who had been engaged in jumping sports when the injury occurred; one had bilateral injury. All the patients were treated by closed reduction and plaster cast immobilization for 4-8 weeks, with satisfactory results. On the basis of our cases and five cases previously reported, the authors would agree with Ryu and Debenham's suggestion that the Watson-Jones classification, which divides avulsion fractures of the tibial tubercle into three types, should be expanded to include this fourth type - avulsion fracture of the proximal tibial epiphysis.